Delayed Fourth Ventricle Outlet Obstruction after Fourth Ventricle Tumor Removal Successfully Treated with Endoscopic Third Ventriculostomy in a Pediatric Patient

Author Info

Félix Pastor-Escartín Pau Capilla-Guasch Vicent Quilis-Quesada Esteban Vega Torres Fernando Talamantes Esbriba José M. González-Darder

Corresponding Author

Pau Capilla-Guasch
Department of Neurosurgery, Hospital Clínlico Universitario de Valencia, Valencia, Spain

A B S T R A C T

Introduction: Fourth ventricle outlet obstruction (FVOO) at the level of Magendie’s and Luschka’s foramina is a rare cause of non-communicating hydrocephalus. Case Report: We present a case of a 15-year-old woman successfully operated on a fourth ventricle WHO grade 1 pilocytic astrocytoma developing a delayed FVOO five months after surgery, when the patient experienced progressive headache, nausea and gate disturbances. Magnetic resonance imaging (MRI) study showed a tetra-ventricular hydrocephalus, with enlargement and bulging of both lateral recesses and Luschka’s foramina. An endoscopic third ventriculostomy (ETV) was successfully performed. Postoperative computed tomography (CT) and MRI studies showed a significant improvement of the hydrocephalus. Conclusion: FVOO is a rare cause of hydrocephalus. Posterior fossa and fourth ventricle microsurgical procedures can produce a delayed FVOO leading to an unexpected deterioration of the clinical status of the patient. The ETV is an effective and safe procedure to treat this unusual condition.

Article Info

Article Type

Case Report

Publication history

Received: Fri 26, Jun 2020
Accepted: Mon 06, Jul 2020
Published: Mon 13, Jul 2020

Copyright

© 2023 Pau Capilla-Guasch. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.GSCR.2020.01.06